Cerebral vasculopathy with aneurysm formation in HIV-infected young adults

The article by Kossorotoff et al. highlights the importance of vigilance for HIV-associated cerebral aneurysms in adults as a cause of stroke.1 They discuss two patients with HIV, ages 23 and 32, who had strokes and were found to have ectasias and aneurysms of the large cerebral arteries (which they term CVA [cerebral vasculopathy with aneurysm]). Although the definitive cause of CVA in HIV-infected persons remains unclear, there is evidence that immune reconstitution in patients with AIDS leads to a vasculopathy complicating a chronic endothelial infection.2 Immune reconstitution inflammatory syndrome (IRIS) is …